Report projects big rise in cancer survivors

More and more people are surviving cancer, thanks to earlier detection and better treatment, and a new report out Wednesday projects the ranks of cancer survivors will grow by nearly a third over the next 10 years.

That’s the good news. The bad news: these 18 million cancer survivors are going to cost the health system a lot of money.

“The increase in the number of survivors will be due primarily to an aging of the population. By 2020, we expect that two-thirds of cancer survivors are going to be age 65 or older,” says Julia Rowland of the National Cancer Institute, which conducted the study.

The NCI says 13.7 million people had survived cancer and were still alive in the U.S. as of Jan. 1, 2012. Nearly two-thirds of them were considered "cured,” having survived five years or more. Forty percent had survived 10 years and 15 percent had lived 20 years past their diagnosis.

“Over the next decade, the number of people who have lived five years or more after their cancer diagnosis is projected to increase approximately 37 percent to 11.9 million,” Rowland’s team writes inthe journalCancer Epidemiology, Biomarkers & Prevention.

Patients with some cancers have an especially rosy outlook. “For patients with prostate cancer, we have a nearly 100 percent five-year survival rate, and breast cancer has made tremendous strides as well, with five-year survival rising from 75 percent in 1975 to almost 89 percent in 2012,” said Rowland.

“However, we clearly need to have better diagnostic tools and better treatments for lung cancer.” Only 15 percent of lung cancer patients live five years, mostly because the symptoms are so vague that people are not usually diagnosed until it has spread.

The big growth in survivorship is only partly driven by better treatments. A bigger factor is the aging of the population, the report says.

Many studies have shown that cancer patients rarely return to full, 100 percent health. The surgery, radiation and chemotherapy that can save their lives takes a toll on their bodies, raising the risk both for second cancers and for other diseases such as heart disease.

“The growing population of cancer survivors will put pressure on a healthcare system in which cancer drug shortages are increasingly common and the demand for oncology services is poised to outpace the supply of oncologists,” the researchers write.

“The growing number of older survivors also presents a unique challenge to the healthcare system because older cancer survivors are more likely to have multiple chronic diseases and tend to experience poorer physical functioning than younger survivors.”

That means a lot of expense. “By 2020, it is estimated that population growth alone will escalate annual costs of cancer care by 27 percent,” the researchers wrote, citing a 2011 study in the Journal of the National Cancer Institute.

“Among survivors who are more than one year post-diagnosis, annual healthcare expenditures are double that of the general population, suggesting that the economic burden of cancer in terms of medical expenditures is both considerable and persistent.”

Cancer is the No. 2 cause of death in the United States, after heart disease, killing more than 500,000 people a year.